Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives

Paliogiannis, Panagiotis; Fois, Alessandro Giuseppe; Sotgia, Salvatore; Mangoni, Arduino A.; Zinellu, Elisabetta; Pirina, Pietro; Negri, Silvia; Carru, Ciriaco; Zinellu, Angelo

doi:10.1183/16000617.0113-2017

Cited by 174 publications

(151 citation statements)

References 56 publications

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“…This simple test can be used to evaluate the severity of the disease and to identify critically affected patients as a result of systemic inflammation. Recent studies have shown that NLR values are highly associated with prognosis of diseases that are related to inflammation such as preeclampsia, endometriosis, chronic obstructive pulmonary disease, appendicitis and various types of cancers …”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have shown that NLR values are highly associated with prognosis of diseases that are related to inflammation such as preeclampsia, endometriosis, chronic obstructive pulmonary disease, appendicitis and various types of cancers. [9][10][11][12][13] In previous reports, white blood cell (WBC) count, C-reactive protein (CRP) levels, sedimentation values, body temperature and TOA diameter were investigated for evaluating the risk factors that cause failure of antibiotic therapy in TOA patients, however, the NLR has not been studied, yet. 14,15 The aim of this study is to compare the NLR in TOA patients who were cured after medical treatment or who underwent surgery or interventional radiologic abscess drainage due to medical treatment failure.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

Alay

Kaya

Karaca

et al. 2019

J of Obstet and Gynaecol

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Aim We aimed to compare the neutrophil‐to‐lymphocyte ratio (NLR) in tubo‐ovarian abscess (TOA) patients who responded to medical treatment or who underwent surgical intervention due to medical treatment failure. Methods The files of the patients, hospitalized in our Obstetrics and Gynecology Department with TOA diagnosis between August 2015 and December 2017, were evaluated retrospectively. The conservative management group was comprised of 38 of the 81 patients (46.9%) who responded to sole medical treatment with the triple antibiotic regimen (gentamicin‐clindamycin‐ampicillin) and the surgical intervention group was comprised of 43 patients (53.1%) who did not respond to medical treatment and needed further surgery and/or interventional radiologic abscess drainage. Demographic and clinical data, imaging findings, and laboratory results including NLR were compared between two groups. Results There were statistically significant differences between the groups in terms of age, TOA diameter, white blood cell and neutrophil counts, and NLR levels (P < 0.05). The mean NLR was 7.4 ± 5.8 for the conservative management group and 10.3 ± 5.8 for the surgical intervention group (P = 0.004). The area under the curve (AUC) for NLR was 0.69 (threshold value was ≥6.97, 95% confidence interval, sensitivity 79.1%, specificity 57.9%). On multiple regression analysis, a significant correlation was identified between age, NLR and resistance to the medical treatment. Conclusion Neutrophil‐to‐lymphocyte ratio and age are significantly higher in patients with medical treatment failure and NLR could be used as a novel marker in addition to white blood cell in the prediction of medical treatment failure in TOA patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

Alay

Kaya

Karaca

et al. 2019

J of Obstet and Gynaecol

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“…Neutrophil-to-lymphocyte ratio (NLR) is another parameter used to evaluate inflammatory status.7 Despite numerous studies conducted in adults, few studies have evaluated NLR in childhood. 21,22 Moreover, most pediatric studies have focused on NLR in asthma. 23,24 Like studies measuring MPV levels, different results have been reported on NLR in asthma.…”

Section: Discussionmentioning

confidence: 99%

Serum eosinophilic cationic protein level and hematological parameters in infants with cow's milk protein allergy

Doğan¹,

Sevinç²

2019

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Background Various biomarkers have been investigated in the diagnosis of cow's milk protein allergy (CMPA) in infants. To our knowledge, no prior studies have evaluated serum eosinophil cationic protein (sECP), neutrophil-lymphocyte ratio (NLR), and mean platelet volume (MPV) concurrently in infants with CMPA. Objective To compare sECP levels, MPV, and NLR in infants with and without CMPA, as well as to investigate the suitability of these parameters as biomarkers in the diagnosis of CMPA. Methods Fifty-six children with CMPA were compared to 40 healthy, similar to distribution of age and sex normal infants as controls. The serum ECP levels were detected by a chemiluminescence assay. The MPV values were calculated by devices in hemogram parameters. The NLR values were obtained by dividing the neutrophil count by the lymphocyte count. Results The median sECP level in the CMPA group was significantly higher than in the control group (23.5 and 9.27 ng/mL, respectively; P=0.001). However, there were no significant differences between groups with regards to median MPV (8.5 and 8.6 fL, respectively; P=0.149) and median NLR (0.35 and 0.37 respectively; P=0.637). Correlation analysis of sECP level with MPV and NLR in the CMPA group revealed no significant relationships (P>0.05 for both). In the Receiver-operating characteristic (ROC) curve analysis, the optimal cut-off levels to identify CMPA for sECP, MPV, and NLR were 18.4 ng/mL (60.7% sensitivity, 97.5% specificity, and AUC: 0.831), 10.05 fL (54% sensitivity, 77.5% specificity, and AUC: 0.413) and 0.97 (14.3% sensitivity, 50% specificity, and AUC: 0.528), respectively. Conclusions The sECP level and blood eosinophil count are significantly higher in infants with CMPA, but MPV and NLR do not differ between infants with and without CMPA. There are also no significant correlations in the CMPA group between sECP and MPV, as well as sECP and NLR. Serum ECP might be useful as a potential biomarker for diagnosing CMPA.

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“…White blood cell count, neutrophil-to-lymphocyte ratio, and eosinophil-to-basophil ratio were used as inflammatory biomarkers, given their established role in the pathogenesis of COPD. [46][47][48] Individual-level sociodemographic covariates comprised age, sex, highest qualification, and employment status. Highest qualification was a five-factor variable (coded as none; O levels, General Certificate of Secondary Education, or Certificate of Secondary Education; A levels or AS levels; National Vocational Qualification, Higher National Diploma, Higher National Certificate, or other profess ional qualification; college or university degree), while employment status was a three-factor variable (coded as employed; retired; and unemployed, home maker, others).…”

Section: Methodsmentioning

confidence: 99%

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Sarkar

Zhang

et al. 2019

The Lancet Planetary Health

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Background The role of environmental exposures in chronic obstructive pulmonary disease (COPD) remains inconclusive. We examined the association between environmental exposures (PM 2·5 , greenness, and urbanicity) and COPD prevalence using the UK Biobank cohort data to identify key built environment correlates of COPD. MethodsIn this cross-sectional, observational study we used baseline data for UK Biobank participants. Included participants were aged 39 years and older, white, had available spirometry data, and had complete data for phenotypes and exposures. COPD was defined by spirometry with the 2017 Global Initiative for Chronic Obstructive Lung Disease criteria. Environmental exposures were PM 2·5 derived from monitoring data and interpolated using land-use regression at the participants' geocoded residential addresses. Built environment metrics of residential greenness were modelled in terms of normalised difference vegetation index from remotely sensed colour infrared data within a 500 m residential catchment, and an urbanicity index derived from spatial analyses and measured with a 1 km buffer around each participant's residential address. Logistic regression models examined the associations between environmental exposures and COPD prevalence adjusting for a range of confounders. Subgroup analyses by urbanicity and effect modification by white blood cell count as an inflammatory marker were also done. FindingsWe assessed 96 779 participants recruited between April 4, 2006, and Oct 1, 2010, of which 5391 participants had COPD with a prevalence of 5·6%. Each 10 µg/m³ increment in ambient PM 2·5 exposure at a participant's residential location was associated with higher odds of COPD (odds ratio 1·55, 95% CI 1·14-2·10). Among the built environment metrics, urbanicity was associated with higher odds of COPD (1·05, 1·01-1·08 per interquartile increment), whereas residential greenness was protective, being associated with lower odds of COPD (0·89, 0·84-0·93 for each interquartile increment in greenness). The results remained consistent in models of COPD defined as per lower limit of normal criteria. The highest quartile of white blood cell count was associated with lower lung function and higher COPD risk with a significant interaction between PM 2·5 and white blood cell count only in the model of lung function (p=0·0003).Interpretation In this study of the built environment and COPD, to our knowledge the largest done in the UK, we found that exposure to ambient PM 2·5 and urbanicity were associated with a higher risk of COPD. Residing in greener areas, as measured by normalised difference vegetation index, was associated with lower odds of COPD, suggesting the potential value of urban planning and design in minimising or offsetting environmental risks for the prevention and management of COPD.

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Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives

Cited by 174 publications

References 56 publications

The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

Serum eosinophilic cationic protein level and hematological parameters in infants with cow's milk protein allergy

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

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